Provider Demographics
NPI:1245690890
Name:YAVORSKY, JULIANA CAROLINE (DPT)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:CAROLINE
Last Name:YAVORSKY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42080 STATE ST STE A
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-5173
Mailing Address - Country:US
Mailing Address - Phone:760-568-2894
Mailing Address - Fax:760-346-4179
Practice Address - Street 1:42080 STATE ST STE A
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-5173
Practice Address - Country:US
Practice Address - Phone:760-568-2894
Practice Address - Fax:760-346-4179
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT296677225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP01710727OtherRR MEDICARE
OR500705177Medicaid
ORP01710727OtherRR MEDICARE